Angiotensin II-Receptor Antagonists: An Overview

Raquel Dina and Mahtab Jafari

Am J Health Syst Pharm. 2000;57(13)

Formulary Recommendations

Angiotensin-II-receptor antagonists seem to be as effective as ACE inhibitors for treating hypertension and can be initiated in patients who are unable to tolerate an ACE inhibitor. All available AT-II-receptor antagonists seem to be equally effective in reducing both systolic and diastolic blood pressure, and they are comparable in cost.

Losartan is unique among AT-II-receptor antagonists in that it has the ability to increase uric acid excretion, which in turn lowers plasma uric acid levels 22 ; however, the clinical importance of this characteristic has yet to be determined.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Next Section

Cite this: Angiotensin II-Receptor Antagonists: An Overview - Medscape - Jul 01, 2000.

Abstract and Introduction
The Renin-Angiotensin Receptor System
Inhibitors of the Renin- Angiotensin System
Losartan Potassium
Valsartan
Irbesartan
Candesartan Cilexetil
Eprosartan Mesylate
Telmisartan
Tasosartan
Comparative Efficacy
Adverse Reactions
Drug Interactions
Cost
Instructions for the Patient
Indications
Formulary Recommendations
Conclusion
References

Table 1. Comparison of Angiotensin II-Receptor Antagonists
Drug	Active Metabolite	Bioavailability (%)	Daily Dose (mg)	Half-life (hr)	Cost ($)a
Losartan	Yes	33	25-100	2 (losartan) 6-9 (EXP-3174)	38
Valsartan	No	25	80-320	6	36
Irbesartan	No	60-80	150-300	11-15	36
Candesartan	No	42	8-32	3-4 3-11	36
Eprosartan	No	13	600-800	5-9	37
Telmisartan	No	42-58	20-80	24	39

a Estimated cost, based on average wholesale price (Drug Topics Red Book, 1999), to the pharmacist for a one-month supply at the usual starting dosage.

Table 2. Clinical Trials Comparing Angiotensin-II-Receptor Antagonists with Angiotensin-Converting-Enzyme Inhibitors a
a	Losartan dosages are expressed in terms of losartan potassium, and candesartan dosages are expressed in terms of candesartan cilexetil. BP = blood pressure, SBP = systolic blood pressure, DBP = diastolic blood pressure, NR = not reported, HCTZ = hydrochlorothiazide.
b	Primary efficacy variable was assessed after eight weeks of therapy.

Comments

Commenting is limited to medical professionals. To comment please Log-in.

Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.

processing....

Angiotensin II-Receptor Antagonists: An Overview

Formulary Recommendations

Tables

Tables

References

Authors and Disclosures

Authors and Disclosures

Comments

Email This

Feedback